Jasper Smits Ph.D.

Run Away from Smoking

On September 19th, CNN Health reported on the role of exercise in improving smoking cessation among teen boys. Smoking prevention and cessation in teens is a crucial public health effort. Smoking is the country's number-one killer that can be prevented—every year almost one-half million individuals die because they smoked. And while smoking rates have been declining over the last decade, new smoking starts among teens continue to be an issue—despite prevention efforts, there has been a dramatic but temporary rise in smoking among this age group.

Among novel approaches to smoking cessation, exercise appears to hold promise. A host of research studies have shown that exercise reduces nicotine withdrawal and cigarette cravings, and therefore may help protect smokers from relapsing. A second possible mechanism for the beneficial effects of exercise on smoking cessation stems from the mood benefits of exercise. After all, smokers consistently report that they smoke in response to negative emotional states—most commonly anxiety, depression, and anger. Also, those who smoke to cope with moods have particularly difficult times quitting.

Indeed, relapse to smoking among those trying to quit often occurs in situations involving negative moods such as anxiety and depression. Exercise interventions provide a good match to these smoking patterns. As we discuss in Exercise for Mood and Anxiety Disorders, regular exercise can have powerful effects on mood, reducing feelings of stress, hostility, anxiety, and depression. In fact, these mood benefits are often felt within minutes of completing exercise. Because it is difficult for most Americans to get to and maintain a regular program of exercise, Exercise for Mood and Anxiety Disorders devotes a wealth of attention to managing issues of motivation, while working to make every exercise session more enjoyable.

At present, we have a large-scale clinical study underway to test the utility and effects of exercise and other wellness approaches to improving smoking cessation outcomes among this group of vulnerable smokers (see quitsmokingdallas). This research is funded by the National Institute on Drug Abuse, and is designed to see if an organized program of exercise or wellness education, added to a standard program for smoking cessation (nicotine replacement patches combined with cognitive-behavior therapy) improves quit rates.

In many ways, this is the adult version of the study discussed in the CNN Health blog. That blog discussed the results of a recent study appearing in the journal Pediatrics. One of the more surprising findings from that study was that it seemed to work better for boys than girls. Here is what the study involved: 233 teens from 19 public schools in West Virginia were randomly assigned to either prescribe a brief intervention (BI); a standardized smoking intervention called "No on Tobacco (NOT); or NOT plus a physical activity component (NOT+FIT). The brief intervention involved a 15-minute advice session, whereas teens receiving the NOT intervention met once weekly for 10 weeks covering a host of topics to help smoking cessation. Those assigned to receive NOT+FIT were also asked to exercise, log their exercise sessions, and wear a pedometer. The study assessed all the teens for six months and found that smoking abstinence at the end of the study was more likely among teens who received the NOT or NOT+FIT interventions than those who received BI. Interestingly, though, the added exercise component did not appear to result in better outcomes for girls (i.e., smoking cessation rates were 13.46 percent for girls in NOT and 4.76 percent for girls in NOT+FIT). However, for boys exercise did appear to result in greater abstinence rates (i.e., smoking cessation rates were 7.89 percent for boys in NOT and 23.68 percent for boys in NOT+FIT).

More research is needed to understand this difference between boys and girls in the teen sample, but in the mean time, there appears to be no wrong reason to add exercise to a smoking cessation program. Exercise reduces risk for many major diseases, improves mood, and can help some people stop smoking. In other words, even if exercise does not help you quit smoking, it can still help save your life, and make your life feel better in the process.

Copyright Jasper Smits

Drs. Michael Otto and Jasper Smits are authors of Exercise for Mood and Anxiety Disorders: Proven Strategies for Overcoming Depression and Enhancing Well Being.